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She has been declining over the past year but was aware and able to eat alone. Today she could not speak clearly or follow simple directions or eat unaided. She also is very sleepy. None of this is characteristic. Have any of you seen sudden cognitive drops like this?

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I don't know if it's characteristic but the fact that she can't sleep, eat alone or follow directions makes me wonder if she's had a stroke. I'd get her either to a doctor or the ER ASAP.
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I would report any change in mental status to her doctor. It could be a number of things causing it.
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Thanks for your answers. Mom recovered by afternoon after sleeping for awhile and was "normal" the next day. I think it might be the beginning of a new stage in the dementia. Typically there are ups and downs during the day and between days, but this one was more severe so I didn't recognize it.

My original question was if any of you had experienced similar things. I always feel a bit shocked when new behaviours and stages occur and it seems sometimes like shifting sand under my feet; I just get used to things and develop some coping strategies when other things pop up. I'm always off balance and scrambling for solid ground, but with this horrible disease it's always just out of reach.
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My loved one had sudden drops in both her physical and mental abilities. She was diagnosed with Vascular dementia mixed with AD. She went from living alone to not being able to care for herself at all. She went from using a cane to being in a wheelchair in less than three months. She's still in the wheelchair.

Her abilities change a lot from week to week. In August she didn't recognize my mom at first. Only after she told her who she was did she seem to remember her.

For over nine months she forgot how to use her hands to push the wheels on her wheelchair. She would just use her feet. I would show herw ho and she would catch on, but a minute later she would forget. Then suddenly, a couple of months ago, she regained her ability to do it. I was so shocked and pleased.

She eats well, but she doesn't look well to me. The illness just seems to take a toll. Despite good blood sugars, good blood pressure, nutrition, etc.

She likes to sleep in too, but I think the Memory Care staff get her up in the mornings anyway. I'm not sure how far they progress before they stay in bed a lot. If your loved one is sleep a lot, she could also suffer depression. You might discuss that with her doctor.

My loved one can eat unassisted, but the food has to be in small pieces and right in front of her. If I serve her a burger, I have to unwrap it, as she doesn't know how to do that.
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